Characteristics of septic arthritis in human immunodeficiency virus-infected haemophiliacs versus other risk groups

The cases are presented of four haemophiliacs infected with human immunodef iciency virus (HIV) and with septic arthritis among the 340 patients follow ed at our centre. The data of these cases and 39 additional HN-infected hae mophiliacs with septic arthritis, identified in a literature search, are re viewed. The spectrum of bacterial pathogens is limited and somewhat differe nt from that in other risk groups. The localization is exclusively to joint s affected by haemophilic arthropathy. The laboratory picture is characteri zed by the absence of peripheral leucocytosis, Varying CD4-helper cell coun ts, a high erythrocyte sedimentation rate and fever. The clinical picture m imics that of haemarthrosis, often causing a delay in diagnosis. Treatment with systemic antibiotics is often sufficient, obviating the need for arthr otomy and open drainage. Prognosis related to the joint function is relativ ely good, but poor when related to the medium- to long-term survival of the patient.